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KMID : 0371320090760030154
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Journal of the Korean Surgical Society
2009 Volume.76 No. 3 p.154 ~ p.158
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Following of the Omentum Preserving Gastrectomy for Advanced Gastric Cancer without Serosa Exposure
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Kim Ji-Hoon
Oh Sung-Tae
Yook Jeong-Hwan
Park Kun-Choon
Kang Sung-Hwa
Kim Byung-Sik
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Abstract
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Purpose:The generally accepted standard surgery for advanced gastric cancer is gastrectomy with D2 dissection accompanied by omentectomy. Theoretically, advanced gastric cancer without serosa exposure cannot disseminate metastasis to the omentum. However, the significance of routine omentectomy in survival remains unproved.
Methods: From January 2000 to December 2002, 174 patients, who diagnosed T2 gastric adenocarcinoma pathologically, underwent curative gastrectomy by one operator. 52 patients underwent omentum-preserving gastrectomy and 122 patients underwent gastrectomy with resection of omentum. We compared clinicopathologic characteristics, recurrence patterns, recurrence rate and survival rates between the two groups.
Results: Five-year survival rate was 82.9% in the omentum-preserving group and 85.2% in the omentectomy group (P=0.729). Moreover, there was no significant difference in recurrence rate between the two groups (P=0.298). In the omentum-preserving group, 3 peritoneal (25%), 4 local (33.3%), 4 hematogenous (33.3%), 1 distant lymph node (8.3%) recurrences were shown. However, in the omentectomy group, 7 peritoneal (35%), 6 local (30%), 6 hematogenous (30%), 1 distant lymph node (5%) recurrences were shown (P=0.935).
Conclusion: These results suggest that the omentum-preserving gastrectomy may be applicable to advanced gastric cancer without serosa exposure, and that it is not necessary to perform uniform omentectomy for all advanced gastric cancer. (J Korean Surg Soc 2009;76:154-158)
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KEYWORD
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Omentum preserving gastrectomy, Omentectomy, Advanced gastric cancer
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